Concussion Flashcards
a concussion is considered ___ brain injury
mild
red flags post truama for brain injury
excessive drowsiness or lethargy, difficulty being woken up, confusion/disorientation, abnormal behaviour/irritability, seizure activity (abnormal movements, eye deviation, loss of consciousness, episodes of loss of bowel/bladder control, biting tongue), blurred vision, slurred speech, SEVERE headache, persistent uncontrollable/forceful vomiting, abnormal clumsiness, inability to walk, sudden weakness on one side of the body, blood/fluid from nose or ears, bruising around eyes or ears
If any present, GO TO HOSPITAL ASAP
If no red flags, f/u in 24-72hrs
T/F in children, CT head rules states that you should get a CT only when you suspect a sign of basal skull fracture, large/ boggy hematoma or if it was a dangerous mechanism of injury
false. it’s required FOR ALL CHILDREN.
Symptoms characteristics considered “high risk “ for neurological intervention and thus need a CT
minor head injury plus any of the following:
- High Risk: GCS <15 at 2h after injury
- suspected open/depressed skull fracture
- hx of worsening headache, irritability
Medium Risk: any sign of basal skull fracture, large/boggy hematoma of scalp, dangerous mechanism of injury
T/F you can give NSAIDS in concussion
false. no sleeping meds/aspirin/NSAIDS
Management: limit mental (1wk off school is normal) + physical activities (return to play protocol, see picture), sleep, no EtOH, no sleeping meds/aspirin/NSAIDs, no driving
Do not sit in a dark room and do nothing
If the patient has protracted recovery, then a slow increase in physical and cognitive activity is recommended. Complete bed rest is not recommended
Post concussion syndrome definition and symptoms
def: history of head trauma with symptom onset by a maximum of 4wks
symptoms: 3+ of the following symptoms categories
- Headache, dizziness, malaise, fatigue, noise intolerance
- Irritability, depression, anxiety, emotional lability
- Subjective concentration, memory/intellectual difficulties without neuropsychological evidence of marked impairment
- Reduced alcohol intolerance
- Preoccupation with above symptoms and fear of brain damage with hypochondria concerns
Post-traumatic epilepsy (PTE) refers to recurrent and unprovoked post-traumatic seizures (PTS) that occur at least_____ after traumatic brain injury (TBI).
Post-traumatic epilepsy (PTE) refers to recurrent and unprovoked post-traumatic seizures (PTS) that occur at least 1 week after traumatic brain injury (TBI). Seizures during the first week after TBI are considered to be provoked by the head injury and known as early PTS.
how are chronic traumatic encephalopathies anatomically diagnosed?
Description: progressive neurodegenerative disease believed to be caused by repetitive trauma to brain including concussions and sub-concussive blows.
Symptoms: begin most often decades after the brain trauma, and usually continue to worsen.
Investigations: only diagnosed post-mortem→ tauopathies, clustering deep into the sulci.
CTE is NOT prolonged post-concussion syndrome
NOT just cumulative effects of concussion
